Chapter 59A, Article 61 NMSA 1978 may be cited as the “Pharmacy Benefits Manager Regulation Act”. History: Laws 2014, ch. 14, § 1; 2017, ch. 16, § 1. ANNOTATIONS The 2017 amendment, effective June 16, 2017, deleted “Sections 1 through 6 of this act” and added “Chapter 59A, Article 61 NMSA 1978”.
As used in the Pharmacy Benefits Manager Regulation Act: A. “maximum allowable cost” means the maximum amount that a pharmacy benefits manager will reimburse a pharmacy for the cost of a generic drug; B. “maximum allowable cost list” means a searchable, electronic and internet-based listing of drugs used by a pharmacy benefits manager setting the […]
A. A person shall not operate as a pharmacy benefits manager unless licensed by the superintendent in accordance with the Pharmacy Benefits Manager Regulation Act and applicable federal and state laws. A licensee shall renew the licensee’s pharmacy benefits manager license annually. B. An initial application and a renewal application for licensure as a pharmacy […]
A. A pharmacy benefits manager shall determine a reimbursement amount for a generic drug based on objective and verifiable sources. B. A pharmacy benefits manager shall reimburse a pharmacy an amount no less than the amount that the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate in the same network for providing the same […]
A. A pharmacy benefits manager shall not require that a pharmacy participate in one contract in order to participate in another contract. B. A pharmacy benefits manager shall provide to a pharmacy by electronic mail, facsimile or certified mail, at least thirty calendar days prior to its execution, a contract written in plain English. C. […]
A pharmacy benefits manager licensed pursuant to the Pharmacy Benefits Manager Regulation Act shall be subject to Section 61-11-18.2 NMSA 1978. A pharmacy benefits manager shall not reduce or eliminate payment on an adjudicated claim except as permitted by Section 61-11-18.2 NMSA 1978. History: Laws 2014, ch. 14, § 6; 2019, ch. 269, § 5. […]
A. A pharmacy benefits manager shall not charge a pharmacy a fee related to the adjudication of a claim, including: (1) the receipt and processing of a pharmacy claim; (2) the development or management of a claim processing or adjudication network; or (3) participation in a claim processing or claim adjudication network. B. A pharmacy […]
A pharmacy services administrative organization shall register with the superintendent on a form and in a time frame and method of submission specified by the superintendent. History: Laws 2019, ch. 269, § 7. ANNOTATIONS Effective dates. — Laws 2019, ch. 269, § 8 made Laws 2019, ch. 269 effective July 1, 2019.
